Dysfunctional High-Density Lipoproteins Are Associated With a Greater Incidence of Acute Coronary Syndrome in a Population at High Cardiovascular Risk: A Nested Case-Control Study
Authors' conclusion
Low cholesterol efflux capacity values, pro-oxidant/proinflammatory HDL particles, and low HDL levels of sphingosine-1-phosphate and apolipoprotein A-I were associated with increased odds of acute coronary syndrome and its manifestations in individuals at high cardiovascular risk.
Study context
- Population
- Individuals at high CV risk in the PREDIMED cohort (Mediterranean or low-fat diet)matched 1:2
- Comparison
- High-density lipoprotein (HDL) functional characteristics in ACS cases vs matched controls
- Casesn = 167
- Outcome
- Incident ACS
Methodological detailsnested within the PREDIMED randomised trial cohort, individually matched 1:2
- Nested within the PREDIMED randomised trial cohort
- Individually matched 1:2
Main finding
As reported in the abstract
ACS, OR per 1-SD increment (adjusted for HDL-C and CV risk factors)
Odds ratio per 1 SD (95% CI)
Cholesterol efflux capacity
0.58(0.40–0.83)
Sphingosine-1-phosphate
0.70(0.52–0.92)
Apolipoprotein A-I
0.58(0.42–0.79)
HDL oxidative-inflammatory indexmarginally linked
1.27(0.99–1.63)
Per 1-SD increment, as printed
Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR1SD (95% CI) | |
|---|---|---|
| MI, OR per 1-SD incrementCholesterol efflux capacity | 0.33 (0.18–0.61) | |
| MI, OR per 1-SD incrementSphingosine-1-phosphate | 0.60 (0.40–0.89) | |
| MI, OR per 1-SD incrementApolipoprotein A-I | 0.59 (0.37–0.93) | |
| Unstable angina, OR per 1-SD incrementHDL oxidative-inflammatory index | 1.53 (1.01–2.33) | |
| Unstable angina, OR per 1-SD incrementApolipoprotein A-I | 0.52 (0.31–0.88) | |
| 0.20.5125Odds ratio per 1 SD (log scale) |
Original publication
Dysfunctional High-Density Lipoproteins Are Associated With a Greater Incidence of Acute Coronary Syndrome in a Population at High Cardiovascular Risk: A Nested Case-Control Study. Circulation. Published 16 January 2020. doi:10.
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